Emergency Department Utilization for Adnexal Torsion: An Analysis of the Nationwide Emergency Department Sample from 2006 to 2018.

Study Objective: To characterize emergency department (ED) utilization for adnexal torsion (AT) among adult patients in the United States.

Design: Retrospective analysis to identify primary AT diagnoses and ED utilization. Other variables analyzed included primary payer type, income quartile by ZIP code, hospital teaching status, and urban vs rural location.

To Robot or Not To Robot: The Use of Robotics in Benign Gynecologic Surgery.

The use of robotic-assisted laparoscopic surgery has continued to grow since the Food and Drug Administration approval for robotic-assisted gynecologic surgery in 2005. However, despite this growth in utilization, the data supporting its use in benign gynecologic surgery has not strongly supported its advantages over conventional laparoscopy. Controversy exists between supporters of robotic-assisted laparoscopic surgery and conventional laparoscopy.

Effects of Shared Decision Making on Opioid Prescribing After Hysterectomy.

Objective: To evaluate the effects of shared decision making using a simple decision aid for opioid prescribing after hysterectomy.

Methods: We conducted a prospective quality initiative study including all patients undergoing hysterectomy for benign, nonobstetric indications between March 1, 2018, and July 31, 2018, at our academic institution. Using a visual decision aid, patients received uniform education regarding postoperative pain management.

Risk Factors for Emergency Department Visits After Hysterectomy for Benign Disease.

Objective: To identify the incidence, indications, and risk factors for emergency department visits that do not result in readmission within 30 days of hysterectomy for benign disease.

Methods: We conducted a secondary data analysis of hysterectomies for benign disease using the Michigan Surgical Quality Collaborative, a statewide group of hospitals that voluntarily reports perioperative outcomes. Hysterectomies for benign disease were abstracted from January 1, 2013, to July 2, 2014.

Risk Factors and Outcomes for Conversion to Laparotomy of Laparoscopic Hysterectomy in Benign Gynecology.

Objective: To estimate the incidence and factors for conversion to laparotomy in women scheduled for laparoscopic hysterectomy for benign gynecologic indications and to examine the effect of conversion on patient outcomes.

Methods: A retrospective cohort study of a Michigan multicenter prospective database was abstracted from January 1, 2013, through July 2, 2014. Participants were collected from an all-payer quality and safety database maintained by the Michigan Surgical Quality Collaborative.

A Favorability Score for Vaginal Hysterectomy in a Statewide Collaborative.

Unlabelled: STUDY OBJECTIVE: Because it is associated with fewer complications and more rapid recovery, the vaginal approach is preferred for benign hysterectomy. Patient characteristics that traditionally favor a vaginal approach include adequate vaginal access, small uterine size, and low suspicion for extrauterine disease. However, the low proportion of hysterectomies performed vaginally in the United States suggests that these data are not routinely applied in clinical practice.

New paradigms in the diagnosis and management of endometriosis.

Purpose Of Review: Endometriosis is a common gynecologic condition estimated to affect 10-15% of reproductive-aged women, 30% of women with subfertility, and 80% of women with chronic pelvic pain. Although mainstays of diagnosis and treatment are still commonly applied, there have been various advances in the modalities of diagnosis and management of this complex condition. This article provides an updated review of novel findings regarding the diagnosis and management of this challenging disease.

Prevalence of Endometriosis During Abdominal or Laparoscopic Hysterectomy for Chronic Pelvic Pain.

Objective: To estimate the prevalence of surgically confirmed endometriosis in women undergoing laparoscopic or abdominal hysterectomy, including those with and without preoperative indications of chronic pelvic pain or endometriosis, and to describe characteristics and operative findings associated with surgically confirmed endometriosis in women undergoing hysterectomy for chronic pelvic pain.

Methods: A retrospective cohort study was performed with 9,622 women who underwent laparoscopic or abdominal hysterectomy for benign indications in the Michigan Surgical Quality Collaborative from January 1, 2013, to July 2, 2014. The prevalence of surgically confirmed endometriosis, determined by review of the operative report and surgical pathology, was calculated for the entire cohort and for subgroups of women with and without chronic pelvic pain or endometriosis.

Implications of sleep-disordered breathing in pregnancy.

Objective: The objective of the study was to examine the relationship between sleep-disordered breathing (SDB) and adverse pregnancy outcomes in a high-risk cohort.

Study Design: This was a planned analysis of a prospective cohort designed to estimate the prevalence and trends of SDB in high-risk pregnant women. We recruited women with a body mass index of 30 kg/m(2) or greater, chronic hypertension, pregestational diabetes, prior preeclampsia, and/or a twin gestation.

Preeclampsia and Sleep-Disordered Breathing: A Case-Control Study.

Objective: To determine whether sleep-disordered breathing (SDB) is more prevalent among women with preeclampsia than among normotensive controls.

Study Design: Preeclamptic patients admitted to the hospital for observation and normotensive, gestational age matched controls hospitalized for obstetrical indications other than preeclampsia were recruited for an overnight sleep evaluation. Watch-PAT100, a validated wrist-mounted, ambulatory device designed to diagnose SDB, was used to complete all sleep studies.

A unique pathology associated with pelvic pain and adnexal mass.

Objective: To present a unique case of pelvic pain.

Design: Case report.

Setting: Academic institution.

Meteorological factors and timing of the initiating event of human parturition.

The aim of this study was to determine whether meteorological factors are associated with the timing of either onset of labor with intact membranes or rupture of membranes prior to labor-together referred to as 'the initiating event' of parturition. All patients delivering at Evanston Hospital after spontaneous labor or rupture of membranes at ≥20 weeks of gestation over a 6-month period were studied. Logistic regression models of the initiating event of parturition using clinical variables (maternal age, gestational age, parity, multiple gestation and intrauterine infection) with and without the addition of meteorological variables (barometric pressure, temperature and humidity) were compared.